LVN Case Manager SNP - La Palma, CA

Company: UnitedHealth Group
Location: Buena Park
Posted on: June 18, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)The LVN Case Manager is responsible for managing low and moderate risk Special Needs Population (SNP) and Dual Eligible (DE) members. SNP / CMC Care Manager will ensure that the SNP and DE receive an assessment. Ensures the individualized care plan is developed and presented timely to the IDCT.Primary Responsibilities:

• Manages a case load of 400 - 600 low to moderate risk SNP and or CMC members
• Coordinates and schedules all IDCT meetings
• Ensures all SNP and DE members are presented at IDCT at least annually
• Facilitates Primary Care Provider attendance
• Ensures SNP and DE member and or caregiver participation
• Oversees the low-risk SNP and DE population and ensures the annual review of the care plan is completed for those members who did not have a change in health status
• Works collaboratively with the patient, physician, family/significant other and providers of healthcare to implement plan of care to meet the individual needs
• Works collaboratively with discharge planners at the affiliated hospitals and case management staff to identify changes in health status
• Monitors care, which is easily accessible with no access barriers as related to the patient's available benefits
• Provides accurate and up - to - date information to practitioners regarding clinical practice guideline criteria and patient information
• Creates individualized treatment plans that incorporate the HRA, community LTSS servicesYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interestedRequired Qualifications:
  • High School Diploma or GED
  • Current and unrestricted LVN license for the state of California
  • 1+ years of experience in a managed care environment, preferably in an IPA or MSO. Other case management experience will be considered
  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
  • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliancePreferred Qualifications:
    • Bachelor's degree in nursing (BSN)
    • Associates Degree in Nursing (ASN)
    • Case Management Certification (CCM)
    • Experience as a case manager, experience with utilization management
    • Experience working with Medicare members
    • Knowledge of and experience with the utilization of UM criteria such as Milliman & Robertson, Medicare and Medicaid guidelines, health plan criteria, etc.
    • Bilingual Spanish speaking (ability to read, write, speak)To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Buena Park , LVN Case Manager SNP - La Palma, CA, Healthcare , Buena Park, California